Provider Demographics
NPI:1710709886
Name:REACH HIGHER PSYCHOLOGICAL SERVICES LLC
Entity type:Organization
Organization Name:REACH HIGHER PSYCHOLOGICAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ADDAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:WAWRZONEK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:412-716-2345
Mailing Address - Street 1:1027 BRIDGEGATE CT NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2201
Mailing Address - Country:US
Mailing Address - Phone:412-716-2345
Mailing Address - Fax:
Practice Address - Street 1:1027 BRIDGEGATE CT NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2201
Practice Address - Country:US
Practice Address - Phone:412-716-2345
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-29
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty